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Health Insurance

Anthem Terminates Cigna Merger, but Refuses to Pay Out $1.8B

May 15, 2017 - After a court ruling in Delaware, Anthem has notified Cigna that their proposed $54 billion merger is off, but that doesn’t mean the two insurance companies are amicably parting ways. Anthem has stated that it will not pay Cigna a $1.85 billion merger termination fee due to the company’s belief that Cigna did not meet the legal requirements for receiving the money. “In light...


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Anthem Terminates Cigna Merger, but Refuses to Pay Out $1.8B

by Jesse Migneault

After a court ruling in Delaware, Anthem has notified Cigna that their proposed $54 billion merger is off, but that doesn’t mean the two insurance companies are amicably parting ways. Anthem has stated that it will not pay Cigna a $1.85...

Patient Incentives from Payers Encourage Preventive Care Visits

by Jesse Migneault

To reduce payer claim costs, would you pay members to go see their doctor once a year?  That’s the premise for a wave of patient incentive programs currently being offered by health insurance companies. For healthcare insurance payers,...

Anthem Pursues Cigna Merger Up to the Supreme Court

by Jesse Migneault

Just seven days after a court upheld the initial ruling which blocked Anthem’s acquisition of Cigna, the nation’s second largest insurer is not giving up.   Anthem has confirmed that it is filing a writ of certiorari with...

Pharmacy Benefit Managers Help Reduce Payer Drug Spending

by Jesse Migneault

Pharmacy benefit managers (PBMs) are instrumental in helping payers provide appropriate access to prescriptions, expand access, and rein in drug spending, according to a recent report from the Pharmaceutical Care Management Association (PCMA)....

Aetna Posts Q1 Loss After ACA Withdrawal, Merger Collapse

by Jesse Migneault

After a tumultuous 2016, Aetna announced a first-quarter 2017 net loss of $381 million, a significant  reversal from a $737 million profit a year ago. Aetna blamed the loss on costs associated with its attempted merger with Humana,...

Payers Offer 10 Ways to Improve Cost, Quality of Long-Term Care

by Jesse Migneault

The National Association of Insurance Commissioners (NAIC) issued ten long term care (LTC) federal policy recommendations to Congress.   The report was completed as part of the group’s Retirement Security Initiative.  NAIC...

Medicaid Service Equals or Surpasses Private Health Payers

by Jesse Migneault

A new report by the Commonwealth Fund found that Medicaid provides equal or better quality health coverage to private health insurance plans.  The Commonwealth Fund’s 2016 Biennial Health Insurance Survey measured statistics related...

PA Seeks Increased Payer Coverage of Emergency Air Ambulances

by Jesse Migneault

Emergency air ambulances save lives, but they can also leave patients in a mountain of debt.  Pennsylvania Insurance Commissioner Teresa Miller would like payers to shoulder more of the costs of these critical services, and has accordingly...

Health Insurance Actuaries Propose Ways to Stabilize Market

by Jesse Migneault

A stable health insurance marketplace is good for payers and consumers. Speculation over potential payer mergers, repeal or modification of the ACA, and the future of high-risk and low income subsidy payments have left premium rates and coverage...

Affordable Care Act Cuts Uninsured Rate by 6.4% Since 2013

by Jesse Migneault

From 2013 to the end of 2016, the percentage of individuals without health insurance dropped across the nation, according to a recent Gallup-Healthways study. The national percentage of those without health insurance went from 17.3 percent in...

UnitedHealth Grows by 11.8% Despite ACA Marketplace Withdrawal

by Jesse Migneault

Despite its very public near-total withdrawal from the Affordable Care Act marketplace in 2017, the nation’s largest healthcare payer recently reported substantial Q1 profit growth.     Revenues at UnitedHealth were...

Payers Face 9.6% Underwriting Loss on Health Insurance Exchange

by Jacqueline Belliveau

Underwriting margins for payers selling individual plans on the health insurance exchange dropped from a 6 percent earned premium loss in 2014 to a 9.6 percent loss in 2015, Milliman recently reported. The financial losses stemmed from the Affordable...

HHS Offers Waivers for Health Insurance Exchange Stability

by Jacqueline Belliveau

The Department of Health and Human Services (HHS) recently encouraged states to apply for State Innovation Waivers as a way to stabilize the health insurance exchanges and boost consumer access health plans and services. States should particularly...

CMS Proposes New Rule to Stabilize Health Insurance Exchanges

by Jacqueline Belliveau

CMS recently announced a proposed rule designed to help stabilize health insurance exchanges by promoting more coverage options and improving the risk pool for insurers. The proposed rule comes just one day after Humana publicized its decision...

Federal Court Blocks Aetna-Humana Health Insurance Merger

by Vera Gruessner

Today, a federal judge ruled that the health insurance merger between the healthcare payers Aetna and Humana should be blocked on the grounds that it would create antitrust issues, according to The New York Times. The health insurance...

How Blue Cross Health Plans Affect Anthem-Cigna Merger Lawsuit

by Vera Gruessner

The Anthem-Cigna merger lawsuit has brought significant evidence to light ever since the case began on November 21, 2016. The Department of Justice has been able to illuminate that the health insurance merger would create major market concentration...

Senate, House of Representatives Pass 21st Century Cures Act

by Vera Gruessner

This week, Congress passed the 21st Century Cures Act. President Obama signed the legislation into law on Tuesday, December 13. The 21st Century Cures Act passed with bipartisan support 94-5 in the Senate and 392-26 in the House of Representatives....

How Health Payers Could Help Reduce High Out-of-Pocket Costs

by Vera Gruessner

A major problem still impacting consumers within the health insurance market is the potential for seeing high out-of-pocket costs. Many individuals are still underinsured despite the significant decrease in the uninsured rate around the country...

Health Insurance Merger Lawsuit Considers Efficiencies Factor

by Vera Gruessner

On Monday, November 21, the court trial filed by the Department of Justice against the health insurance merger between Anthem and Cigna began. The drive to stop the $48 billion health insurance merger started due to concerns over a negative impact...

Rise in High-Deductible Health Plans Requires Cost Transparency

by Vera Gruessner

High-deductible health plans are becoming more and more common across the health insurance industry. With the many changes that the Affordable Care Act (ACA) has brought, payers are attempting to control costs by offering more high-deductible...

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